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Major Depression Index (MDI)

Calculators  Neurology
Major depression index (MDI) is a tool to calculate the svereity of the depression.
Have you felt low in spirits or sad?
At no time 0
Some of the time 1
Slightly less than half of the time 2
Slightly more than half of the time 3
Most of the time 4
All the time 5
Have you lost interest in your daily activities?
At no time 0
Some of the time 1
Slightly less than half of the time 2
Slightly more than half of the time 3
Most of the time 4
All the time 5
Have you felt lacking in energy and strength?
At no time 0
Some of the time 1
Slightly less than half of the time 2
Slightly more than half of the time 3
Most of the time 4
All the time 5
Have you felt less self-confident?
At no time 0
Some of the time 1
Slightly less than half of the time 2
Slightly more than half of the time 3
Most of the time 4
All the time 5
Have you had a bad conscience or feelings of guilt?
At no time 0
Some of the time 1
Slightly less than half of the time 2
Slightly more than half of the time 3
Most of the time 4
All the time 5
Have you felt that life wasn’t worth living?
At no time 0
Some of the time 1
Slightly less than half of the time 2
Slightly more than half of the time 3
Most of the time 4
All the time 5
Have you had difficulty in concentrating, e.g. when reading the newspaper or watching television?
At no time 0
Some of the time 1
Slightly less than half of the time 2
Slightly more than half of the time 3
Most of the time 4
All the time 5
Have you felt very restless?
At no time 0
Some of the time 1
Slightly less than half of the time 2
Slightly more than half of the time 3
Most of the time 4
All the time 5
Have you felt subdued or slowed down?
At no time 0
Some of the time 1
Slightly less than half of the time 2
Slightly more than half of the time 3
Most of the time 4
All the time 5
Have you had trouble sleeping at night?
At no time 0
Some of the time 1
Slightly less than half of the time 2
Slightly more than half of the time 3
Most of the time 4
All the time 5
Have you suffered from reduced appetite?
At no time 0
Some of the time 1
Slightly less than half of the time 2
Slightly more than half of the time 3
Most of the time 4
All the time 5
Have you suffered from increased appetite?
At no time 0
Some of the time 1
Slightly less than half of the time 2
Slightly more than half of the time 3
Most of the time 4
All the time 5
Result:

Background

Measured Factor
MDI score
Measured Factor Disease
  • Depressioin
Measured Factor Detail
MDI score represents the severity of the depreesion in patients by addition of the points which inclues the question regarding to the daily basis behavioural changes of an individual.
Speciality
Psychiatrist
Body System
Neurology
Measured Factor Low Impact
  • score of <20 indicates that there is no depression.
Measured Factor High Impact
  • Scores between 25-29 indicates that there is mild to moderate depression and Scores ≥30 indicates the severe depression.

Result Interpretation

Ranges Ranges
  • Critical High: ≥30
  • Normal: Less then 20
Result High Conditions
  • Severe depression
False Positive
  • Impairment
  • Distress
  • Mental health history
References: 3
Test Limitations
Patients with more than one (Axis-I or Axis-II) disorder and other comorbidities can't take advantage of this index
References: 4

Studies

Study Validation 1
The purpose of this study was to validate the performance of major-depression-index in measuring severity of depressive states. A total 91 patients were involved in the study. Patients were categorized based on the score range from no depression to measured depression according to Hamilton Depression Scale (HAM-D). Rasch analysis was used for evaluation of validity. Results showed that the internal validity of MDI was accurate. The external validity was also determined as the total score of the MDI correlated significantly with the HAM-D (Pearson's coefficient 0.86, P < or = 0.01, Spearman 0.80, P < or = 0.01). This study concluded that MDI has satisfactory internal and external validity.
References: 5
Study Validation 2
The aim of this study was to evaluate the applicability and internal validity of Major Depression Inventory (MDI) when measuring severity of depressive states using the total scale score as a sufficient statistic. 43 patients with suspected depressive states were selected for the study. The sensitivity and specificity of MDI was assessed covering a data of depressive symptoms. Results showed sensitivity varied between 0.86 and 0.92 for major depression and variation in specificity was 0.82 and 0.86. Cut-off score for MDI while using total score was 26. This study concluded that MDI was had a adequate sensitivity and specificity in measuring depressive state of patients
References: 6
Study Validation 3
The objective of this study was to validate the web based version of the Major Depression Inventory (MDI) against a fully structured telephonic interview in patients who were suspected as depressive (presence of two or three core symptoms of depression). 132 suspected with depressive symptoms were recruited in study. According to the MDI, depression was rated based on yes/no questions. Sensitivity, specificity, and positive predictive value of the International Classification of Diseases, Tenth Revision (ICD-10) algorithms of the MDI were analyzed. Results  according to MDI showed that 59.1% of the of total subjects was depressed, with severe depression in 31.8% population. The sensitivity of the MDI for depression was 62.1% (95% confidence interval [95% CI]: 52.6–70.9) and the specificity was 62.5% (95% CI: 35.4–84.8). This study concludes that with only few false-positive diagnoses MDI can be a effective tool for diagnosing ICD-10 depression in a clinical setting compared to the M-CIDI (telephonic conversation)
References: 7
Study Additional 1
This study was conducted to evaluate the correlation between depression assessed by Major Depression Inventory (MDI) and depression assessed by psychiatrists using Schedules for Clinical Assessment in Neuropsychiatry (SCAN)  Two cohorts were included in the study with 10488 subjects in cohort 1 and 1093 subjects in cohort 2. A questionnaire including the MDI was sent out to cohort 1 population and subjects in cohort two were examined by Psychiatrists using SCAN. The specificity sensitivity and Kappa of MDI method was 0.22, 0.67 0.25 and when depression was assessed using SCAN specificity sensitivity and Kappa was found to be 0.44, 0.51 and 0.33. Cut-off scores when using the MDI total score were also calculated. This study concluded that The MDI had a high internal consistency when cut-off scores at 19/20 was used in population-based samples.
References: 8
Study Additional 2
This study aimed to evaluate the the internal consistency of the Major Depression Inventory (MDI) in an epidemiological study in rural Kenya. 1496 subjects with age between 13-24 years were surveyed. MDI using a computer-assisted system was administered to measure the depressive symptoms. Cronbach’s alpha and the Omega Coefficient methods were used to evaluate the internal consistency of MDI. Results of this study showed that internal consistency using both Cronbach’s Alpha (α= 0.83) and the Omega Coefficient (0.82; 95% confidence interval 0.81- 0.83) was above adequate thresholds. 3.6% youth were at risk of major depression while in 8.7% subjects showed presence of depression (mild, moderate or severe). Females and older youth were at the highest risk of depression. This study concluded that MDI had a good internal consistency with high power to diagnose psychometric properties. Its easy to use and high reliability can make this criteria a decisive in conducting various epidemiological studies of depression
References: 9

References

  1. Olsen LR, Jensen DV, Noerholm V, Martiny K, Bech P. The internal and external validity of the Major Depression Inventory in measuring severity of depressive states. Psychol Med. 2003;33(2):351-6.
  2. Bech P, Rasmussen NA, Olsen LR, Noerholm V, Abildgaard W. The sensitivity and specificity of the Major Depression Inventory, using the Present State Examination as the index of diagnostic validity. J Affect Disord. 2001;66(2-3):159-64.
  3. Klinkman MS, Coyne JC, Gallo S, Schwenk TL. False positives, false negatives, and the validity of the diagnosis of major depression in primary care. Arch Fam Med. 1998;7(5):451-61.
  4. Bech P, Timmerby N, Martiny K, Lunde M, Soendergaard S. Psychometric evaluation of the Major Depression Inventory (MDI) as depression severity scale using the LEAD (Longitudinal Expert Assessment of All Data) as index of validity. BMC Psychiatry. 2015;15:190.
  5. Olsen LR, Jensen DV, Noerholm V, Martiny K, Bech P. The internal and external validity of the Major Depression Inventory in measuring severity of depressive states. Psychol Med. 2003;33(2):351-6.
  6. Bech P, Rasmussen NA, Olsen LR, Noerholm V, Abildgaard W. The sensitivity and specificity of the Major Depression Inventory, using the Present State Examination as the index of diagnostic validity. J Affect Disord. 2001;66(2-3):159-64.
  7. Nielsen MG, Ørnbøl E, Bech P, Vestergaard M, Christensen KS. The criterion validity of the web-based Major Depression Inventory when used on clinical suspicion of depression in primary care. Clin Epidemiol. 2017;9:355-365.
  8. Forsell Y. The Major Depression Inventory versus Schedules for Clinical Assessment in Neuropsychiatry in a population sample. Soc Psychiatry Psychiatr Epidemiol. 2005;40(3):209-13.
  9. Otiende M, Abubakar A, Mochamah G, Walumbe D, Nyundo C, Doyle AM, et al. Psychometric evaluation of the Major Depression Inventory among young people living in Coastal Kenya. Wellcome Open Res. 2017;2:113.